Usability Testing – An Aphasia Perspective

This paper reports the experience of participating in usability testing from the perspective of a person with aphasia. We briefly report adaptations to classic usability testing to enable the participation of people with aphasia. These included the use of short, direct tasks and physical artefacts such as picture cards. Authors of the paper include Ian, a user with aphasia who participated in adapted usability testing and Abi, a speech and language therapist researcher who facilitated sessions. Ian reports that these methods allowed him, as a person with aphasia, to engage with the usability testing process. We argue that such adaptations are essential in order to develop technologies which will be accessible to people with aphasia. This collaborative report provides a case for both how and why these adaptations can be made

Co-Created Personas: Engaging and Empowering Users with Diverse Needs Within the Design Process

Personas are powerful tools for designing technology and envisioning its usage. They are widely used to imagine archetypal users around whom to orient design work. We have been exploring co-created personas as a technique to use in co-design with users who have diverse needs. Our vision was that this would broaden the demographic and liberate co-designers of their personal relationship with a health condition. This paper reports three studies where we investigated using co-created personas with people who had Parkinson’s disease, dementia or aphasia. Observational data of co-design sessions were collected and analysed. Findings revealed that the co-created personas encouraged users with diverse needs to engage with co-designing. Importantly, they also aforded additional benefts including empowering users within a more accessible design process. Refecting on the outcomes from the diferent user groups, we conclude with a discussion of the potential for co-created personas to be applied more broadly

Empowering Expression for Users with Aphasia through Constrained Creativity

Creative activities allow people to express themselves in rich, nuanced ways. However, being creative does not always come easily. For example, people with speech and language impairments, such as aphasia, face challenges in creative activities that involve language. In this paper, we explore the concept of constrained creativity as a way of addressing this challenge and enabling creative writing. We report an app, MakeWrite, that supports the constrained creation of digital texts through automated redaction. The app was co-designed with and for people with aphasia and was subsequently explored in a workshop with a group of people with aphasia. Participants were not only successful in crafting novel language, but, importantly, self-reported that the app was crucial in enabling them to do so. We refect on the potential of technology-supported constrained creativity as a means of empowering expression amongst users with diverse needs

Experimental Investigation on the Effects of Website Aesthetics on User Performance in Different Virtual Tasks

In Human-Computer Interaction research, the positive effect of aesthetics on users\u27 subjective impressions and reactions is well-accepted. However, results regarding the influence of interface aesthetics on a user\u27s individual performance as an objective outcome are very mixed, yet of urgent interest due to the proceeding of digitalization. In this web-based experiment (N = 331), the effect of interface aesthetics on individual performance considering three different types of tasks (search, creative, and transfer tasks) is investigated. The tasks were presented on an either aesthetic or unaesthetic website, which differed significantly in subjective aesthetics. Goal orientation (learning versus performance goals) was included as a possible moderator variable, which was manipulated by using different task instructions. Both aesthetics and goal orientation were a between-subject factor, leading to a 2 x 2 between subject design. Manipulation checks were highly significant. Yet the results show neither significant main effects of aesthetics and goal orientation on performance regarding both accuracy and response times in each of the three tasks, nor significant interaction effects. Nevertheless, from a practical perspective aesthetics still should be considered due to its positive effects on subjective perceptions of users, even as no substantial effects on user performance occurred in the present experiment

Reporting on psychological well-being of older adults with chronic aphasia in the context of unaffected peers

Abstract Purpose: It is important that professionals working with individuals with acquired neurogenic communication disorders consider their clients’ psychological wellbeing. Much is known about the significant emotional, social and psychological consequences of aphasia after stroke, however little is known about individuals’ psychological wellbeing. This paper reports the psychological wellbeing of community-dwelling older adults with chronic aphasia in the context of their unaffected peers. Method: Thirty participants affected by aphasia and 75 unaffected participants completed the 24-item measure How I Feel About Myself drawn originally from Ryff (1989) and the Geriatric Depression Scale (Sheikh & Yesavage, 1986). Results: Individuals with aphasia after stroke had statistically similar range and average psychological wellbeing as the unaffected population, with the exception of lower environmental mastery (independence) and lower mood. Furthermore, a substantial number of individuals (affected and unaffected) reported lower than average psychological wellbeing. Conclusions: Many persons with chronic aphasia need support to manage the demands and responsibilities of their everyday lives and raise their mood. Clinicians need to be aware of this possibility and formally assess all persons with aphasia, as well as explore the potential impact of physical limitations. Identifying low well-being in older adults is important for all professionals working with the ageing population. The implications for speech and language therapy and for multi-disciplinary research and cross-sector joint working (health, social and community services) are discussed

MaLT - combined motor and language therapy tool for brain injury patients using Kinect

Background: The functional connectivity and structural proximity of elements of the language and motor systems result in frequent co-morbidity post brain injury. Although rehabilitation services are becoming increasingly multidisciplinary and "integrated", treatment for language and motor functions often occurs in isolation. Thus, behavioural therapies which promote neural reorganisation do not reflect the high intersystem connectivity of the neurologically intact brain. As such, there is a pressing need for rehabilitation tools which better reflect and target the impaired cognitive networks. Objectives: The objective of this research is to develop a combined high dosage therapy tool for language and motor rehabilitation. The rehabilitation therapy tool developed, MaLT (Motor and Language Therapy), comprises a suite of computer games targeting both language and motor therapy that use the Kinect sensor as an interaction device. The games developed are intended for use in the home environment over prolonged periods of time. In order to track patients' engagement with the games and their rehabilitation progress, the game records patient performance data for the therapist to interrogate. Methods: MaLT incorporates Kinect-based games, a database of objects and language parameters, and a reporting tool for therapists. Games have been developed that target four major language therapy tasks involving single word comprehension, initial phoneme identification, rhyme identification and a naming task. These tasks have 8 levels each increasing in difficulty. A database of 750 objects is used to programmatically generate appropriate questions for the game, providing both targeted therapy and unique gameplay every time. The design of the games has been informed by therapists and by discussions with a Public Patient Involvement (PPI) group. Results: Pilot MaLT trials have been conducted with three stroke survivors for the duration of 6 to 8 weeks. Patients' performance is monitored through MaLT's reporting facility presented as graphs plotted from patient game data. Performance indicators include reaction time, accuracy, number of incorrect responses and hand use. The resultant games have also been tested by the PPI with a positive response and further suggestions for future modifications made. Conclusion: MaLT provides a tool that innovatively combines motor and language therapy for high dosage rehabilitation in the home. It has demonstrated that motion sensor technology can be successfully combined with a language therapy task to target both upper limb and linguistic impairment in patients following brain injury. The initial studies on stroke survivors have demonstrated that the combined therapy approach is viable and the outputs of this study will inform planned larger scale future trials

Afluentia: suporte à comunicação para afasia fluente

Aphasia is a language disorder caused by brain damage (eg, stroke) that affects a person’s ability to communicate. Involves different degrees of impairment and it can manifest by difficulties in speaking fluently or difficulty finding words (anomia), but can also entail impairment in spoken language comprehension, inability to repeat words or phrases, impairments in written expression (agraphia), in reading comprehension (alexia) or a combination of any of these difficulties. It can thus result in limitations in the way the person with aphasia interacts with others, for instance, to express how they are feeling as well as their needs, making it hard for them to have a more independent life or have their difficulties addressed. Additionally, this condition also has a strong impact in the life of those around them (e.g., family, carers) as the difficulties of communication, should anything happen, can lead to fear of leaving these patients unattended. Several challenges arise when addressing the communication needs of people with aphasia deriving from the diverse and idiosyncratic nature of their condition and although assisted communication tools have been proposed in the literature (e.g. using pictograms), the characteristics of aphasia often render them as partial solutions. In this sense, this project focuses on understanding the characteristics and needs of aphasic patients and also on the proposal of technology-mediated communication tools that address them in their daily lives. This work adopts a user-centered design and development approach to explore how people with aphasia can be supported in their day-today communication resorting to technology mediation. It was thus achieving an iterative design with the development and evaluation of a proof-of-concept solution for communication aspects, which was progressively implemented and refined having in consideration the identified requirements and the continuous evaluation of the proposed solutions, carried out with a focus group composed by a Speech and Language Therapist (SLT) and a Human Computer Interaction (HCI) Expert. After a first version of the system was achieved, an evaluation phase with Speech and Language Therapists with a strong experience with patients with aphasia took place in order to understand and validate the achieved application, which led to more refinement phases. At its current stage of development, evaluation results show a good level of usability and satisfaction and establish Afluentia as promising ground for further evolving the research on communication mediated by technology to support people with aphasia.A afasia é um distúrbio da linguagem provocada por danos cerebrais (por exemplo, acidente vascular cerebral) e que afeta a capacidade de comunicação de uma pessoa. Envolve diferentes graus de deficiência e pode-se manifestar por dificuldades em falar fluentemente ou dificuldade em encontrar palavras (anomia), mas também pode acarretar prejuízo na compreensão da linguagem falada, incapacidade de repetir palavras ou frases, deficiências na expressão escrita (agrafia), na compreensão da leitura (alexia) ou numa combinação de qualquer uma dessas dificuldades. Pode assim resultar em limitações na forma como a pessoa com afasia interage com outras para, por exemplo, exprimir como se está a sentir assim como as suas necessidades, impossibilitando que tenha uma vida mais independente ou tenha as suas dificuldades abordadas. Além disso, a afasia também tem um forte impacto na vida das pessoas ao redor do afásico (por exemplo, familiares, cuidadores), pois as dificuldades de comunicação da pessoa com afasia podem levar ao medo de deixála desacompanhada por aqueles que a rodeiam. Vários desafios surgem ao abordar as necessidades de comunicação de pessoas com afasia decorrentes da natureza diversa e idiossincrática da sua condição e embora ferramentas de comunicação assistida tenham sido propostas na literatura (por exemplo, usando pictogramas), as características da afasia geralmente tornam essas soluções parciais. Nesse sentido, este projeto foca-se na compreensão das características e necessidades dos pacientes afásicos e também na proposta de ferramentas de comunicação mediada por tecnologia que os abordem, no seu cotidiano. Este trabalho adota uma abordagem de design e desenvolvimento centrada no utilizador de modo explorar como as pessoas com afasia podem ser apoiadas na sua comunicação quotidiana recorrendo à mediação tecnológica. Foi assim conseguindo um design iterativo com desenvolvimento e avaliação de uma solução de prova de conceito para aspectos de comunicação, que foi progressivamente implementada e aperfeiçoada tendo em consideração os requisitos identificados e a avaliação contínua das soluções propostas, realizada com um grupo de foco composto por uma Terapeuta da Fala e um Especialista em Interacção Humano Computador. Após a obtenção de uma primeira versão do sistema, uma fase de avaliação com Terapeutas da Fala com forte experiência com pacientes com afasia também ocorreu de modo a entender e validar a aplicação alcançada, o que levou a mais fases de refinamento. Na sua atual fase de desenvolvimento, os resultados da avaliação mostram um bom nível de usabilidade e satisfação e definem o Afluentia como um terreno promissor para evoluir ainda mais a pesquisa em comunicação mediada por tecnologia de suporte a pessoas com afasia.Mestrado em Engenharia de Computadores e Telemátic

How a Diverse Research Ecosystem Has Generated New Rehabilitation Technologies: Review of NIDILRR’s Rehabilitation Engineering Research Centers

Over 50 million United States citizens (1 in 6 people in the US) have a developmental, acquired, or degenerative disability. The average US citizen can expect to live 20% of his or her life with a disability. Rehabilitation technologies play a major role in improving the quality of life for people with a disability, yet widespread and highly challenging needs remain. Within the US, a major effort aimed at the creation and evaluation of rehabilitation technology has been the Rehabilitation Engineering Research Centers (RERCs) sponsored by the National Institute on Disability, Independent Living, and Rehabilitation Research. As envisioned at their conception by a panel of the National Academy of Science in 1970, these centers were intended to take a “total approach to rehabilitation”, combining medicine, engineering, and related science, to improve the quality of life of individuals with a disability. Here, we review the scope, achievements, and ongoing projects of an unbiased sample of 19 currently active or recently terminated RERCs. Specifically, for each center, we briefly explain the needs it targets, summarize key historical advances, identify emerging innovations, and consider future directions. Our assessment from this review is that the RERC program indeed involves a multidisciplinary approach, with 36 professional fields involved, although 70% of research and development staff are in engineering fields, 23% in clinical fields, and only 7% in basic science fields; significantly, 11% of the professional staff have a disability related to their research. We observe that the RERC program has substantially diversified the scope of its work since the 1970’s, addressing more types of disabilities using more technologies, and, in particular, often now focusing on information technologies. RERC work also now often views users as integrated into an interdependent society through technologies that both people with and without disabilities co-use (such as the internet, wireless communication, and architecture). In addition, RERC research has evolved to view users as able at improving outcomes through learning, exercise, and plasticity (rather than being static), which can be optimally timed. We provide examples of rehabilitation technology innovation produced by the RERCs that illustrate this increasingly diversifying scope and evolving perspective. We conclude by discussing growth opportunities and possible future directions of the RERC program